| NPI | 1205813854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F7033) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F7033) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME79208) | |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2022-08-16 |